When hospice reverts to the lowest common denominator and leaders obsess about metrics, it's time to speak. Self-inflated leaders assume clinicians give until their backs break, given no raises for years. A clinical ladder is a rainbow’s pot of gold. Others have a sorrier job and must be motivated by money. Abysmal leaders dangle extrinsic rewards for admission, hiring and EDBITA targets. “Sign on” bonuses entice people into a poor work environment. Employees’ voice equals their raise, zero.

Friday, September 30, 2016

Kindred Pays Record CIA Fine

StrangeTony,

Just in case you missed it. The Office of Inspector General for Health and Human Services announced:

Kindred Health Care, Inc., the nation's largest provider of
post-acute care, including hospice and home health services, has paid a
penalty of more than $3 million for failing to comply with a corporate
integrity agreement (CIA) with the Federal Government, Department of
Health and Human Services' Inspector General Daniel R. Levinson
announced today.It is the largest penalty for violations of a CIA to date, the Office of Inspector General (OIG) said.The record penalty resulted from Kindred's failure to correct
improper billing practicesin the fourth year of the five-year
agreement. OIG made several unannounced site visits to Kindred
facilities and found ongoing violations.

The message from on high is to grow and there's significant pressure to admit patients. It's been that way for years, under both Gentiva and Kindred.

CIA-required audits performed by Kindred's internal auditors in
2013, 2014, and 2015 found that the company and its predecessors had
failed to implement policies and procedures required by the CIA and that
poor claims submission practices had led to significant error rates and
overpayments by Medicare.

Kindred was billing Medicare for hospice care for patients who were
ineligible for hospice services or who were not eligible for the highest
level and most highly paid category of service, OIG said.

That level would be general inpatient care or GIP.

A higher up shared the company refunded over $1 million to Medicare. That fits with the over $3 million penalty as the government levels treble damages. So that's a $4 million hit, all of it due to bad management.

I wonder if this will impact Kindred at Home President David Causby's $1 million bonus due September 2017? He became Gentiva's COO in October 2013. That means Causby was "leading the day-to-day operations of our business" for all but ten months of the period covered in the settlement.

Meeting admission criteria and accurate billing are critical day-to-day operations. For much of the review period Causby was the accountable leader.

Not sure how this is funny. Kindred's management team, like Gentiva's, will use any excuse to line their pockets at the expense of people doing the actual work. This $4 million cash outlay comes at a time management is working on health insurance. We'll see how much worse benefits get all the while management is telling employees how valuable we are and how the company wants to be competitive in the benefit arena.

Management not living up to their CIA promises and continuing unethical behavior should be very concerning to the Board of Directors. It has similar elements to Wells Fargo, just on a smaller scale. Calling it a joke minimizes the situation, especially as it is a record CIA fine.

Sorry, "joke" in this instance refers to the relatively small size of the fine. The million might have be trebled but it definitely wasn't extrapolated across the entire universe of claims as other audits usually are. Good luck to those who actually work for this entity.